‘Mental Healthcare Act has now become a necessity’

The pandemic has added to the troubles of the citizens, leading to a rise in mental health issues. Representation pic

Following psychiatrists, many stakeholders such as activists, lawyers and clinical psychologists have voiced their concern over non-implementation of the Mental Healthcare Act, 2017 in Maharashtra, even after four years of its enactment. mid-day had, in a report on November 18, highlighted that while several states have started implementation of the Act, Maharashtra is yet to take any step.

Nishit Kumar, founder and managing director of Centre for Social and Behaviour Change Communication, said, "Popular perception is that mental illness is equal to ‘pagalpan'. However, it covers anxiety, stress, depression apart from acute conditions such as schizophrenia, delusional behaviour and the likes. Pandemic-related issues including loss of jobs or vocational income, absence of in-person classes for students, limitations on movements have impacted a big part of the population, taking mental health issues to levels akin to a mental health pandemic."

Areas of concern

Kumar listed out a few areas of concern. "WHO estimates indicate that India has the world's highest rate of suicides, and a third of these suicides are reported among people aged between 15 and 29. National Crime Record Bureau (NCRB) estimates that one student commits suicide every hour in India. Maharashtra and Tamil Nadu, two of our most developed states, have the highest rates of student suicides. Recent studies in Mumbai estimated an alarming 60 per cent of teenagers as depressed and prone to high levels of anxiety," he said.

He also said that India spends an abysmal 0.06 per cent of the health budget on mental health which is even lower than Bangladesh. There is also an 87 per cent shortage of mental health professionals with only three psychiatrists per million people. "A government study of 2004-07 found that one in two children in India were sexually abused by the age of 10, irrespective of gender," he said.

What needs to be done

State governments need to work on mission mode to tackle the mental health crisis by rapidly increasing the number of diploma and degree courses related to psychology and counselling - particularly clinical psychology. "Setting up mental health departments in every government organisation and encouraging private sector to do the same, focusing on preventive programmes; setting up mobile mental health centres in rural areas; using mass media to encourage people to understand and invest in mental health are some of the steps that can be taken. We need a crisis-level strategy to tackle the rapidly rising levels of mental health issues," Kumar concluded.

Fundamental right

"Mental health is as much a health concern as any other ailment in the physical sense and cannot be undermined. Therefore, when a person is entitled to a healthy standard of living within the extended meaning of Article 21 of the Constitution, it also includes mental health. It further needs to be understood that a person suffering from a mental health issue cannot be deprived of his human dignity, fundamental and constitutional rights," said Floyd Gracias, Supreme Court counsel.

"The Mental Healthcare Act is actually codification of wider meaning given to the term life used in Article 21 in as much as it recognises valuable rights of a person with mental illness. Such law should have been implemented across the country. However, it is a matter of grave concern that it has not been so implemented by many states including Maharashtra," said advocate Rajeshwar Panchal.

He added, "In fact, in the present conditions caused by Covid-19, we, the people of India, have been going through unprecedented difficult times, be it losing jobs or uncertainty in small scale business, etc. Therefore, now is a time when we need to be provided access to mental healthcare, which this Act provides as a matter of legal right. Non-implementation of such laws results in violation of the fundamental rights guaranteed to us by our Constitution."

‘Act will do wonders'

Dr Shivangi Pawar, a psychotherapist, said, "As per World Health Organization, India is among the countries with the highest rate of depression, schizophrenia and bipolar disorder. The Mental Healthcare Act is a progressive, patient-centric, rights-based Act, and thus comes across as a ray of hope for around 14 per cent of the citizens who suffer from various mental illnesses."

"The implementation of this Act will do wonders as it will certainly bring a huge change in the lives of patients and their caregivers. The poor can get access to free mental healthcare. The patients will also have the right to protection against the cruel and inhuman treatment," she said, adding that the need of the hour is implementation of this Act.